Population pharmacokinetics and pharmacodynamics of meropenem in critically ill patients with renal impairment or on continuous renal replacement therapy.
Purpose: This study aimed to characterize the pharmacokinetics (PK) of meropenem in patients with renal impairment or on continuous renal replacement therapy (CRRT), investigate the factors contributing to PK variability, and evaluate the performance of different dosing regimens to optimize the phar...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 81; no. 11; pp. 1689 - 1699 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188548409&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188548409 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Nov2025 vid: 81 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188548409 187593072 188548409 188548409 10.1007/s00228-025-03910-x 188548409 ppf: 1689 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Population pharmacokinetics and pharmacodynamics of meropenem in critically ill patients with renal impairment or on continuous renal replacement therapy. aug: au: Feng, Chen Bian, Jiangyujing Qu, Yuchen Yu, Yunli Wang, Yueyuan Du, Xin Sun, Yewen Wang, Guanjun Xu, Jiao Zhu, Jianjun Pan, Jie affil: https://ror.org/02xjrkt08 Department of Pharmacy, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, 215004, Suzhou City, Jiangsu, China sug: subj: Continuous Renal Replacement Therapy Renal Insufficiency, Chronic Drug Therapy Meropenem Pharmacokinetics Meropenem Pharmacodynamics Meropenem Therapeutic Use Critically Ill Patients Human Adult Middle Age Aged Aged, 80 and Over China Funding Source Prospective Studies Nonexperimental Studies Meropenem Administration and Dosage Liquid Chromatography-Mass Spectrometry Meropenem Adverse Effects Risk Assessment Glomerular Filtration Rate Intensive Care Units Academic Medical Centers Extracorporeal Membrane Oxygenation Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over ab: Purpose: This study aimed to characterize the pharmacokinetics (PK) of meropenem in patients with renal impairment or on continuous renal replacement therapy (CRRT), investigate the factors contributing to PK variability, and evaluate the performance of different dosing regimens to optimize the pharmacokinetics/pharmacodynamics PK/PD) targets. Methods: This study enrolled patients with severe infections and renal impairment who received meropenem treatment at the Second Affiliated Hospital of Soochow University. Participants were grouped according to whether CRRT was used. Meropenem concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC/MS–MS). A population pharmacokinetic (PPK) model for meropenem was developed using a nonlinear mixed-effects modeling (NONMEM) approach. Monte Carlo simulations were performed to evaluate the likelihood of achieving PK/PD targets and the risk of adverse events across various dosing regimens. Results: A total of 54 patients were included in the study. A two-compartment model was used as a structural model and CRRT was identified as a significant covariate of clearance (CL). The estimated typical value of CL was 2.47 L/h. Under physiological conditions, renal impairment usually leads to a decrease in meropenem clearance. Compared with patients with renal impairment (estimated glomerular filtration rate < 45 mL/min/1.73 m2), CRRT can increase meropenem clearance by 2.1 times. Monte Carlo simulations suggested that for patients undergoing CRRT, the administration regimen of 0.5 g q6h (3 h infusion) is recommended; whereas for non-CRRT patients with renal impairment, the regimen of 0.5 g q8h (1 h infusion) was advised. Conclusions: The study identified that CRRT significantly affected the exposure of meropenem in patients with renal impairment. Therefore, individualized medication for CRRT patients is of great importance. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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